The problem of geographical dispersion is common in clinical academic departments. Often there is a main departmental base in a teaching hospital with various smaller units either elsewhere on the same campus or based in other hospitals in the same city. In addition, staff may do their ward work, out-patient clinics and their associated clinical teaching scattered over a number of sites. Although these arrangements usually have some effects on departmental cohesion, problems can usually be overcome with a little effort and the traditional means of ensuring communication and developing common policies in teaching, research and service development has been to hold regular departmental meetings.